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In seven years of treatment beginning with an extended evaluation/ psychotherapy phase of one year's duration followed by a six-year analysis, a picture emerged shedding light on the resilience of this child who had at first appeared too disturbed and intellectually limited to benefit from an analysis. Her first seventeen months of life were spent with her mother in the otherwise deplorable physical conditions of a Russian
Supervising and Training Analyst and Associate Supervisor in Child and Adolescent Analysis, Baltimore-Washington Institute for Psychoanalysis; Clinical Assistant Professor of Psychiatry, Georgetown University School of Medicine.
Shorter versions of this paper were presented at meetings of the Virginia Psychoanalytic Society and The Association for Child Psychoanalysis. I am grateful to colleagues, particularly Drs. Anita Schmukler, Ruth Fisher, Jack Novick, Barry Landau, Robert Gillman, and members of the Writing Study Group, for comments that were helpful in the final preparation of this paper.
I had the opportunity to discuss Dr. Wayne Downey's paper on the analysis of an adopted Siberian-Russian refugee presented at a Scientific Meeting of the Baltimore-Washington Society for Psychoanalysis in the spring of 2002. I am grateful to Dr. Downey for inspiration to present my own case, using process material from sessions to illustrate details of the analytic work.
* Winner of the Albert J. Solnit Award, 2004
prison cell. From there she went to at least two different orphanages before being adopted by American parents when she was seven and a half. With analytic treatment, Nikita evolved from a traumatized child, whose inner world reflected the many losses and abuses she had suffered, to a competent adolescent equipped to use the loving relationships her adoptive parents offered her. Analysis of defense, labeling of affects, and use of the analyst as a developmental object all contributed to the therapeutic action and to my patient's modification of sadomasochistic and narcissistic defenses allowing her to fully develop her capacity for mentalization.